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A woman with atopy experienced anaphylaxis after taking, among other dietary supplements, a commercial
extract of echinacea. Hypersensitivity was confirmed by skinprick and RAST testing. Regular ingestion of
echinacea by up to 5% of surveyed patients with atopy, combined with detection of echinacea-binding IgE in
atopic subjects (19% by skin testing; 20% with moderate to strong reactivity by RAST testing), raises the
possibility of severe allergic reactions, even with first-time use, due to cross-reactivity with other structurally
similar allergens. Patients with atopy should be cautioned about the risk of developing life-threatening
reactions to complementary medicines, including echinacea.